Office of Research Development
Contact: 9266 1708, radsafety@curtin.edu.au
Radiation Project Approval
(Radioactive Substances)
1
Project
Project title
Start date
2
Duration
Radiation licence holder
The radiation licence holder will preferably be the principal investigator for the project. Where this is not the case, both the
licence holder and the principal investigator must sign this application form. *Attach a copy of the licence.
Name (include title)
School, Centre or Area
Expiry
date
Licence number*
Principal Investigator
(if different)
3
Radiation worker training details
All users of radionuclides must have appropriate radiation safety training.
Name
4
Details of radiation safety qualifications and training
Radionuclides
List all radionuclides and the maximum activities in each location. The locations must be approved radioisotope laboratories.
Nuclide (e.g. H-3)
Maximum Activity
(MBq)
Building and room
(stored and/or
used)
Chemical form
(e.g. Thymidine)
Radiation and contamination monitoring
5
Provide details of instruments for radiation monitoring. List your survey monitors and provide information on personal
dosimeters, biological monitoring, wipe testing etc. The University RSO can provide advice on the best techniques for
radiation monitoring.
Make/model of survey meter
Type of detector
Date of last calibration
No
Yes
☐
☐
No
☐
☐
Yes
☐
No
☐
Have all users been issued with a personal monitoring badge?
Yes
Do users require biological monitoring (required for ≥120 MBq 3H, ≥5 MBq 14C or
35
S, ≥0.1 MBq 125I)?
Will monthly wipe tests be carried out (required for low energy beta emitters)?
Radioactive Substances Project Application Form. Published: June 2015. Version 1.2
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Office of Research Development
Contact: 9266 1708, radsafety@curtin.edu.au
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Radioisotope facility
Check which items are present in the radioisotope laboratory. If unsure or if not applicable to all radioisotopes then leave
unchecked. The University RSO can provide advice on the laboratory requirements.
Does the architecture, plumbing and ventilation meet Regulatory requirements
☐
☐
Room warning signs
Safe working rules
7
Yes
☐
No
Spill kit
PPE
☐
☐
☐
Waste disposal
Solvents must be packaged and not be disposed of down drains.
Packaged waste
Nuclide
Form
Storage
location
Activity
Frequency
Location of
Activity
flushing sink
Description of the procedure
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Include information on: Locations, movement and activities of the radioisotope(s) at each stage, physical processes such as
incubation, injection, centrifuging, filtering, column separation, etc., Number of samples or animals per week with activity per
sample and number of repeats. (Activities should be expressed in becquerels - not counts per minute.)
Declaration
Licence holder and principal investigator: I declare that information in this application is correct, accurately represents the intended
research, and that the research will be performed in accordance with this proposal.
The Radiation Safety Supervisor must also be aware of all radiation project applications in their area. Send completed application form
to University RSO, Office of Research and Development, building 100, or email to radsafety@curtin.edu.au
Licence holder
Name
Signature
Date
Principal investigator (if different from the licence holder)
Name
Signature
Date
Signature
Date
Radiation Safety Supervisor
Name
Office use only
Approval number
Review or expiry date
University Radiation Safety Officer
Name
Signature
Date
Subject to the following conditions
Radioactive Substances Project Application Form. Published: June 2015. Version 1.2
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